Orthopedics. 2008 Sep;31(9):907-8. Haddad FS, Bridgens A.
The key to the optimal management of an acutely infected arthroplasty is an expeditious diagnosis with careful assessment of the mode of presentation and treatment variables to determine the appropriate management strategy. At our institution acute infection is managed early and aggressively with debridement and exchange of mobile parts and change of the implant if it is cementless. For established chronic infection, each case is considered individually, using single-stage exchange in selected circumstances (1 in 6 cases). Two-stage exchange with an articulating spacer is used in the remainder. Single-stage revision offers clinical and economic advantages over a two-stage revision in selected patients, and although ongoing evaluation is still in place, currently we have had no reinfections in our single-stage revision cohort.